Zytiga and PSA

[ForJoel]

I was hoping some of you could shed some light on the following numbers my husband has received since starting Zytiga on 12/28/18. January: 7, Feb: 8.7, March: 8, April: 6.4, May: 6.1. We were hoping that PSA would have gone down farther by now, but we are encouraged that it is dropping. My question is, should we throw chemo at this also? We saw Dr. Armstrong in March, but he couldn't make a call on what to do because he said they don't even look at the PSA for 90 days after starting Zytiga. Our local oncologist was happy with the 6.4, but we haven't gone back yet since the 6.1. He also said that Joel is not "castraint resistant," so I thought that was good.

Should we be concerned it isn't dropping farther, faster?? What are your thoughts, please cast all you knowledge my way!! Thank you!

[pjoshea13]

I don't believe that a faster decline is indicative of a longer time before drug resistance, say.

If the PSA continues to be lower than the month before, celebrate!

-Patrick

[Shooter1]

Mine on Xtandi has been dropping slowly for over a year..did have chemo...then added Xtandi at first rise in PSA during treatment. Now on 1/2 dose Xtandi. 80 mg/ DAY). PSA stable to slow dropping for last year. 0.140 to 0.120 in last 12 mo. Don't get in a hurry. Slow drop is fine.

[Tall_Allen]

As long as it is dropping or stable, stick with it. You can move to docetaxel when it rises.

[Fairwind]

His Gleason score and PSA when diagnosed ?

[ForJoel in reply to Fairwind]

PSA was 114, I’ve never gotten a Gleason score and I have asked

[j-o-h-n in reply to ForJoel]

No Gleason? Was he biopsied? If he was he should know his score. Insist for it from his MO.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 06/05/2019 7:47 PM DST

[pakb]

Depending on his Gleason score you may want to add Docetaxel- not necessarily because PSA isn't going down faster but just to hit it hard at the beginning. My husband is almost 2 years In with Gleason 9 and diagnosed at 49... his still hovers just below 10 PSA. He started at almost 700- but it is taking it's time going down compared to others. E has been on lupron throughout, did Docetaxel with it at the beginning, and has been on lupron, zytiga+Prednisone since stopping Docetaxel. I'm more concerned with the trend of the PSA than what the number is. As long as it is going down...then it is still reacting to treatment and not hormone/castrate resistant.

[jedgar1]

It took me 7 months to go from 2.2 to undetectable on the same drug regiment.

Gleason 4-3 after failures with RP and Radiation.